CPT 00126: Anesthesia for External, Middle, and Inner Ear Procedures
Commercial payers pay $80 on average nationally for this procedure.
CPT code 00126 describes anesthesia services provided for procedures on the external, middle, and inner ear, including biopsy and tympanotomy; the service is an anesthesia procedure typically delivered in the operating room or ambulatory surgery center for ear surgeries that may require general or regional anesthetic management.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 00126 centers near the BUCA average commercial rate of $79.60, with Blue Cross Blue Shield and UnitedHealth Group skewing lower on median and mean measures while Aetna and Cigna sit higher on top-end values. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $37.00, UnitedHealth Group’s spread is the tightest at $30.90, and Aetna’s spread is the widest at $69.00, indicating Aetna has the most dispersion between typical lower- and higher-end negotiated rates.
Looking across payers, UnitedHealth Group’s narrower $30.90 IQR suggests more consistency around its central rate, while Aetna’s $69.00 IQR points to substantial variability among contracts. Blue Cross Blue Shield and BUCA show moderate spreads of $37.00 and $43.80 respectively, and Cigna’s interquartile range is $40.60, placing it between the tightest and widest distributions. These differences reflect how concentrated or dispersed commercial reimbursement tends to be by payer for this code.